HFHS LogoA novel study is taking a closer look at the benefits against risks for lung cancer patients in order to undergo preventative brain radiation therapy as a method to stop cancer from spreading to the brain.

Non-small cell lung cancer is known to be a disease in which cancer cells form inside the tissues of the lung. With non-small cell lung cancer, cancer may perhaps spread in the earlier phase of the disease to other organs, including the brain.

Moreover, this cancer is known to be the most common form of lung cancer. According to the American Cancer Society, about eight to nine out of 10 cases of all lung cancers are believed to be the non-small cell type.

Evidently, there are three main sub-types of non-small cell namely squamous cell carcinoma, adenocarcinoma, and large-cell carcinoma. Squamous cell carcinoma seems to make up approximately 25 to 30 percent of all lung cancers while adenocarcinoma accounts for about 40 percent of lung cancers and is typically found in the outer part of the lung. Also, large-cell carcinoma accounts for about 10 to 15 percent of lung cancers.

This study is known to be part of a national Radiation Therapy Oncology Group (RTOG) analysis of prophylactic cranial irradiation for patients with stage III non-small cell lung cancer.

Earlier studies have discovered this preventative type of external beam radiation therapy that treats the entire brain could reduce the risk of cancer spreading to the brain in patients with non-small cell lung cancer and its sister disease, small-cell lung cancer.

External beam radiation therapy is also known as prophylactic cranial irradiation (PCI). The odds of cancer developing in the brain may rise as people with non-small cell lung cancer live longer with more effective treatments.

In order to examine more about how PCI impacts a patient’s quality of life and cognitive function, Dr. Movsas along with his colleagues were believed to have tracked the development of approximately 340 patients with stage III non-small cell lung cancer for one year after receiving PCI. Apparently, PCI is a 10-minute treatment that occurs once a day for nearly two to three weeks.

The study authors found that patients with non-small cell lung cancer treated with PCI seem to have a considerably decreased risk of developing brain metastases by about 10 percent i.e. from 18 percent to 8 percent in contrast to those who did not receive the treatment.

Although there was no significant impact on quality of life, patients who underwent PCI appear to have a greater decline in immediate memory recall and delayed memory recall as compared to patients who did not have PCI.

Co-author of the study Benjamin Movsas, M.D., chair of the Department of Radiation Oncology at Henry Ford Hospital in Detroit elucidated that, “This study offers patients a look at both sides of the coin with this treatment, allowing them to make an informed decision about their care. Now that we have a more complete perspective and know the challenges, we need to move forward to develop strategies to reduce the risk of neurocognitive changes after brain radiation.”

Already a RTOG study is known to be in progress to test memantine, a medicine approved for Alzheimer’s disease, in order to examine if it may assist in improving memory following brain radiation.

The findings of the study revealed that preventative brain radiation for patients with non-small cell lung cancer seems to reduce the likelihood of developing brain metastases. However, it appears to impact some short-term and long-term memory. The study also revealed that preventative brain radiation may not be able to increase survival and has no considerable impact on quality of life.

“These findings offer a more complete perspective regarding this intervention for patients with non-small cell lung cancer. We now need to develop strategies to help shift the benefit-risk ratio for this treatment,” says Dr. Movsas.

He further claimed that the potential for exploring other strategies for a more accurate treatment that will spare parts of the brain associated with memory. Supposedly, these strategies include making use of newer radiation technologies like intensity modulated radiation therapy.

The findings of the study have been presented at the plenary session for the 51st annual American Society for Radiation Oncology (ASTRO) meeting.